Tag Archives: Salem Cosmetic Dentist

Invisalign as a Retainer?

I am about to finish with my Invisalign treatment. It’s been great and I’ve loved seeing the progress of my teeth. My dentist said I’m going to need to wear a retainer for a time. I’m kind of bummed that after all this time with the invisible treatment I’m going to have to switch to a metal bar. Could I just wear my last pair of aligners as a retainer?

Lana B.

Dear Lana,

Pretty brunette with a beautiful smile
Invisalign can give you a gorgeous smile

I’m so glad you’ve loved your Invisalign experience. They have quite a high patient satisfaction rate. Aren’t you glad we live in the time period we do when we no longer have to wear those uncomfortable metal braces?

Unfortunately, your aligners are designed to be temporary. If you wore them for the length of time you’d need to wear a retainer, it would not only wear through with holes, but would get kind of gross and nasty.

However, I have some good news for you. You won’t have to wear “ye olde metal bar” for your retainer if you don’t want to. Just like braces, retainers have had their own advancements as well.

Options is Retainers

  • Lingual Retainers

While these are metal retainers, they’re placed behind your teeth on the tongue side. No one will be able to see them so you’ll get the invisibility you want.

  • Clear Retainers

You can find two types of these. The first of these are small and cover about half of the tooth, made out of similar material to your aligners, but made for more long-term use. The second covers the whole mouth and can be decorated with a logo from your favorite team or other favorites.

What you’ll need to do is talk to your dentist handling your Invisalign case and discuss these newer options. That way you can get the treatment you need in a way you’re comfortable.

This blog is brought to you by Dr. Randall Burba. Check out his beautiful smile guarantee.

General Dentist or TMJ Specialist?

I have really good teeth. Never had a cavity or any other problems, though I do grind my teeth. I had a checkup a month ago with an all clear. Yet, this week I keep getting an intermittent pain in my teeth. I can’t tell exactly where it’s from. I don’t know if it’s a cavity or not. My cubicle neighbor said she had a similar problem and it turned out to be TMJ. Should I see a general dentist or a TMJ Specialist?

Norma

Dear Norma,

Woman holding her jaw in pain from TMJ

I want to clear up a common misunderstanding. There isn’t a recognized specialty in TMJ Disorder. Any dentist who treats TMJ is just a general dentist who (hopefully) has done additional study and training in TMJ treatment.

We’ll get into how to find a qualified TMJ dentist in a moment. First, let’s address your pain. You don’t have localized pain, but generalized. That makes me think it’s not a cavity. However, if it’s referred pain, that could still make a cavity a possibility.

Your checkup wasn’t too long ago, so unless your dentist missed something a cavity wouldn’t generally pop up and suddenly hurt in that short period of time. Here’s what I’m going to recommend. Go back to see your dentist and get some x-rays done. If by chance it is decay, it’s much easier to get a simple filling than to put it off until it blows up into a dental emergency. So don’t be afraid to go to the dentist and get diagnosed. It’s better than waiting until things are dangerous.

Finding a Qualified Dentist to Treat TMJ

If it turns out there’s not decay or any other typical dental issue, then it will be time to see a TMJ Specialist. So how do you know who is qualified without that true specialty degree? You ask about their TMJ training.

It should be post-graduate and be at some place like one of the following:

  • The Spear Institute
  • The Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies
  • The Kois Center

These are just a few of the advanced training centers, but they’re among the most reputable. If they haven’t done significant post-graduate training, look elsewhere. Additionally, you should know that a good TMJ Dentist will start with the least invasive treatment. They wouldn’t start with a full-mouth reconstruction unless it was a serious and obvious problem where that was the only solution.

Best of luck to you! Hopefully, it’s a simple solution.

This blog is brought to you by Dr. Randall Burba.

What Can Keep My Dentures In?

I’ve had my dentures for a long time. Don’t ask my age. It’s rude. However, I do need advice. Regardless of how old I am, I don’t enjoy being humiliated by having my dentures fall out when I’m in public. So, be a nice young man and tell me how to fix this disaster. I’m almost scared to open my mouth. If you knew how much I loved talking you’d feel very sorry for me right now.

Eleanor

Dear Eleanor,

An image of a snap-on denture
Snap-on Dentures will keep them secure

What’s happening to you is a result of how long you’ve had your dentures. I certainly hope your dentist warned you about the problems with long-term dentures, but based on your question I don’t think he did.

When your teeth were removed, your body began reabsorbing the minerals in your jawbone to use elsewhere. After 10-20 years, there’s not enough jawbone to keep your dentures secure. This is known as facial collapse and the reason yours keep falling out.

Snap-On Dentures Could Be Your Solution

To solve this will take a couple of steps. The first thing you need is to build back up that lost jawbone. A simple outpatient bone grafting procedure can do that for you. Once you’re healed from that you have a few choices. I would never dare ask your age, but it will have an effect on which you choose.

The cheapest solution is to have new dentures made, but remember in a period of time, you’ll face the same issue of a shrunken jaw.

If you want the top-of-the-line tooth replacement option, then I’d get implant supported dentures. These attach your newly made dentures to dental implants. They will last a lifetime and prevent you from any further bone loss. The only drawback is the expense. They come with a hefty price tag.

In between those two treatments, is something called snap-on dentures. I’ve posted a picture of them right after your question. These use just two implants that will snap on to your dentures. They’re not as secure as a full set of implants would be, but they will keep your dentures in.

If you want to, you can add more implants as you’re able.

This blog is brought to you by Dr. Randall Burba.

Can Dentures Be Attractive?

Everyone I know who have dentures have an ugly smile. I’m losing my teeth and need to replace them. I am going to save up for dental implants, but in the meantime I need dentures. I don’t want an ugly smile. Is there a way to get attractive, normal looking dentures?

Kevin

Dear Kevin,

Mature couple smiling
You can have a gorgeous smile no matter what your age!

Yes, you can certainly have an attractive smile with dentures. It’s not the procedure which makes the difference in appearance, but the dentist. In order to have a natural and attractive smile, you need to see a cosmetic dentist with a lot of expertise.

There are different levels of artistry in cosmetic dentists, just like there are better and worse painters and sculptors. Any art is a skill which takes both technical skill, natural talent, and lots of practice. So, how do you find such a dentist?

I suggest you look for a dentist who has reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of expert cosmetic dentists in the world.

Transitioning from Dentures to Dental Implants

I’m sure your dentist has explained the dangers of dentures to you and that’s why you’re saving up for dental implants. One thing you could do starting out is to get snap-on dentures. This can be done with as few as two dental implants and will at least get you started.

Make sure that whoever you go to for your dentures also has some expertise in dental implants as well, especially because you’re going to be transitioning. They can do your snap-on dentures or even complete removable dentures in a way that will make the process easier.

The Danger of Dentures

In case your dentist didn’t explain why implants are the better option I’m going to put it here for you and for the benefit of others. Once you remove your teeth, your body will begin reabsorbing the minerals in your jawbone to use elsewhere throughout your body. This causes your jawbone to begin shrinking. Eventually, you won’t have enough jawbone left to even retain your dentures, making it nearly impossible for you to eat. This process is known as facial collapse.

Dental implants prevent facial collapse because the root form tricks your body into thinking you still have natural teeth there and it leaves the mineral in place, saving your jaw bone structure.

This blog is brought to you by Dr. Randall Burba.

How Do I Find the Best Dentist?

I’ve recently moved and need to find a new dentist. I’ve been to the same one most of my adult life so it feels weird switching. How do I find the best one available?

Burt

Dear Burt,

Woman giving thumbs up in a dental chair
The Best Dentists Leave Us with Smiles

Wouldn’t it be great if there was some independent, objective measurement to tell us who the best dentists were? Unfortunately, especially when it comes to general dental care, there isn’t. That doesn’t mean I can’t give you some guidelines to help you find the best dentist for your particular needs.

The first thing to ask yourself is what type of services do you need? Are you strictly and nuts and bolts guy who just wants his teeth cleaned and maintained as necessary? Or maybe you also want some cosmetic work done? Once that’s decided, it gets a little easier.

Finding the Best General Dentist

For the basics, I’d simply do an internet search for dentists in your area. Then I’d take two additional steps.

  • Check their reviews.

You’ll want a dentist people enjoy seeing. One who makes them feel like family instead of just someone they need to get in and out of the dental chair. Reviews are generally written by those who are thrilled with the service they’ve received or hated it. Either one should give you the information you need.

  • Check their passion

Each state has a requirement for how many continuing education hours a dentist has to do to keep their license. You want a dentist who not only keeps up with the developments in his field but has a passion for it. Make sure they go above and beyond what is required. They shouldn’t be offended to answer a question on how many continuing hours they do.

Finding the Best Cosmetic Dentist

It’s a little easier to find the best cosmetic dentist. Because there isn’t a cosmetic dentistry specialty, there used to be no way for patients to know who would give them a gorgeous smile makeover with porcelain veneers and who would give them a cosmetic horror story.

Fortunately, the American Academy of Cosmetic Dentistry stepped in and created an accreditation program. This tests dentist both with written and oral exams gauging their technical knowledge. Then, it requires them to provide visual evidence of a large number of cosmetic procedures they’ve done to ensure they not only have technical skill but artistry as well.

If a dentist is AACD accredited, that means you will get a stunning smile. In fact, most of them have a beautiful smile guarantee.

This blog is brought to you by Dr. Randall Burba.

Can a Dental Crown Cause TMJ

I’ve had a problem over the last month of my jaw aching, especially in the morning. I’ve been under some stress and have caught myself tensing my jaw some throughout the day. Then, I got a dental crown. It’s made the pain so much worse. I went back to the dentist…several times. He’s adjusted it several times, but the pain never seems to go away now, plus, it’s always hitting my other teeth before the others. Could this be causing TMJ?

Beatrice

Dear Beatrice,

Woman holding her jaw in pain

Yes, a poorly placed crown can certainly cause or exacerbate existing TMJ problems. There is a lot that goes into understanding how the bite should go together. Some dentists invest more time and training in that area than others. You may have a dentist who doesn’t invest much in it.

The fact that your teeth are not meeting uniformly is a cause of concern and he should know that. Some dentists who have trouble getting it right will just adjust and adjust until the patient is too embarrassed to keep complaining and drop it. This needs to be fixed.

The fact that your jaw had already had some minor pain and you’d noticed some clenching during the day worries me too. If you notice clenching during the day, you almost certainly are doing it at night as well. You should be wearing a nightguard. They’re custom fit to your bite and comfortable. Their function is to protect your teeth and jaw from the pressures of clenching and grinding.

Finding a TMJ Dentist

It doesn’t sound like your dentist is going to deal with this properly, so you need to see one who understands TMJ. While there isn’t a recognized TMJ Specialty, there are ways to know if a dentist has a good knowledge of the condition.

You’ll want to especially look at their post-graduate training. Don’t feel weird asking them about it. It’s important knowledge for you in choosing the right dentist. For instance, Dr. Stanley Burba invested significant training on TMJ Disorder. He’s studied at both the Spear Institute and the Dawson Academy.

Some other great centers are the Kois Center and the Las Vegas Institute for Advanced Dental Studies (LVI). If a dentist has trained at any of these institutes, they’re sure to be able to help you.

Additionally, if it turns out that your dental crown isn’t properly placed the new dentist can help you get a refund from your current dentist.

This blog is brought to you by Dr. Randall Burba.

Are Pretty Dentures Possible After 20 Years?

I’ve had dentures for 20 years. I’ve never liked them and have been quite embarrassed about my smile ever since. I now mostly smile with my lips closed. But, things have been getting quite worse. Lately, they’ve been painful and difficult to keep in. They’ve even fallen out once while I was in public. Talk about humiliating. This likely means I need a new pair of dentures. Since there have been 20 years of developments in dentistry, I’m hoping that means dentures can be made pretty now? Pretty please tell me that’s the case.

Alexandra M.

Dear Alexandra,

Mature couple smiling
You can have a gorgeous smile no matter what your age!

I hate hearing stories like yours. It saddens me to know you’ve spent this much time ashamed of your smile. You’re right that there have been improvements in the dental field. In fact, there’ve been remarkable improvements. I’ll share several of them in a moment. First, I want you to know that you can definitely have a gorgeous smile, even with dentures. You could have when you first received dentures, too, had your dentist been skilled in the cosmetic end of dental care.

Let’s start with the beauty of dentures. Even back when you received your dentures, a skilled, artistic cosmetic dentist could have prepared a stunning set of dentures for you where you’d be thrilled to share your smile with the world. However, now you have a second chance to get that gorgeous smile.

Fixing Your Denture Problems

The reason your dentures no longer fit properly and are falling out is a condition known as facial collapse. It’s a result of the length of time your teeth have been removed. You can learn more about this on our problems with dentures page. The end result, however, is you no longer have enough jawbone to support any form of tooth replacement, including dentures.

All is not lost, though. The first thing you’ll need to do is have some bone grafting done. This is a relatively simple procedure (if the dentist knows what they’re doing) which can build back up the jawbone that you’ve lost. It can be done in one appointment, but you will need some healing time afterward for the bone to be secure.

After that, you have several options:

  • Get New Dentures Made

DenturesObviously, the first solution is to just have new dentures made. If you want them to be beautiful, though, you’ll need to go to a skilled cosmetic dentist. There isn’t really a cosmetic dentist specialty, so any general dentist can perform cosmetic procedures. The problem with that is their results vary. So, you need to do some research to determine if this is a skilled artistic dentist or not.

The absolute easiest way to do that is to simply go to an AACD accredited dentist. The AACD is the American Academy of Cosmetic Dentistry. Their accreditation program is designed to weed out the pretenders from the truly artistic cosmetic dentists. If a dentist has reached accreditation level with the AACD, you can be assured you’ll get a beautiful smile.

You do need to be aware, though, is if all you do is get dentures again, you’ll still face your jawbone shrinking and have to go through this whole procedure all over again in about 10 to 20 years.

  • Get Dental Implants

Illustration of a dental implantThe best way to prevent dealing with facial collapse after you’ve had your bone structure repaired is to get dental implants instead of dentures. These implant prosthetic roots into your jawbone causing your body to realize there is still a need to support your teeth, which leaves your jawbone completely intact. However, some people find dental implants out of their budget. Fortunately, there is a middle ground.

  • Get Snap-on Dentures

Salem Snap on DentureThese are dentures which are supported by dental implants. They’re considerably more affordable than a full set of implants and can help your dentures stay in place. Obviously, the more implants the better the support, but you can get them with as few as two. Then, as you’re able, you can add more implants to secure them further and protect additional bone.

I hope this helps with your situation.

This blog is brought to you by Dr. Randall Burba.

Press-on Veneers versus Cosmetic Dentist

I don’t have a very good cosmetic dentist. He’s great for a lot of general dental work, but even he admits his cosmetic work needs work of a different kind. I appreciate his honesty but it leaves me in kind of a bind. I want to get porcelain veneers. He said he’s fine with me going to another, more experienced cosmetic dentist for that particular procedure. He even recommended someone he said was AACD accredited. He said that’s a huge deal. Not sure why. Anyway, I went to the AACD guy and had a free consultation. He was nice and I could tell by his picture gallery of patients that he does great work, but his prices were through the roof. Today I saw this website for press-on porcelain veneers. The pictures looked pretty to me and they were A LOT less expensive than the guy my dentist recommended. Do you know about these press ons? Are they really as good as the ones by a cosmetic dentist?

Veronica M.

Dear Veronica,

A single porcelain veneer being held up by a dental instrument

First, I really appreciate the honesty of your dentist. Some, less caring practitioners might be tempted to just do their “best” porcelain veneers knowing they’d be subpar but wanting the practice or the money. Instead, he was forthright and even suggested another, more qualified, dentist.

Not just that, he was careful to recommend an accredited dentist with the American Academy of Cosmetic Dentistry (AACD). These are the top 1% of cosmetic dentists in the world. Yes, their prices are sometimes a bit higher (though not always). That’s usually because they’re so skilled and artistic that they’re in high demand with patients wanting cosmetic procedures, such as porcelain veneers. In fact, there are people who travel across the country or even from other countries to have their work done by them.

If you went to one of them you would definitely get a stunning smile. Probably every one of them has some form of a beautiful smile guarantee.

Porcelain Veneers versus Press-on Veneers

The press-on veneers you saw on that website are completely different from the veneers you’d get from a skilled, artistic cosmetic dentist. They’re more similar to what you’d get with a snap-on smile. They’re made from a composite resin and just press over your teeth temporarily. While they may look great for a photo shoot, they do not look nearly as stunning or natural in person.

Because the press-ons fit over your teeth, instead of being custom made and bonded to your teeth, they tend to come off a bit bulky and a little long. It can make it difficult for patients to speak when they’re in.

There are some procedures you can shop around and cut corners on. Teeth whitening is one example. It doesn’t really matter which dentist does that procedure. It’s fairly straightforward. Going for the cheapest dentist, in that case, will do no harm. Veneers are different. They require expertise in both technique and artistry.

If you want a true smile makeover, it’s an investment that will last a lifetime, giving you stronger confidence than you’d imagine.

This blog is brought to you by Dr. Randall Burba.

Will I Have to Have Surgery for Dentures?

I’m trying to figure out whether or not to get dentures or dental implants. I hate the idea of surgery so was leaning toward dentures. But, wonder if they require surgery too.

Jack B.

Dear Jack,

An illustration of both a denture and a dental implant

I think when it comes to deciding between two procedures, I’d first look at the long-term effects. Once you know how they’ll affect your quality of life, then you can weigh that against placement procedures.

Dentures Versus Dental Implants

Dentures are a removable tooth replacement option. The top arch stays in by suction. The bottom arch sits on the ridge of your jawbone. They have several “downsides” but I’ll just give the biggest. Once your teeth are removed, your body will reabsorb the minerals once used by your jawbone to help you keep the roots of your teeth in place. Without those minerals, your jawbone will begin to shrink. After a while, you’ll lose so much bone that you won’t have enough to keep in your dentures. This is known as facial collapse because of the way it makes your face look shrunken and prune-like.

Dental Implants are permanent. Prosthetic root forms, either titanium or zirconia, will be surgically implanted into your jawbone. After a period of healing you’ll have dental crowns placed on top. Aside from the obvious benefits of being just like having your natural, healthy teeth back, implants preserve your jawbone. No matter how many years you have them, they’ll protect you from facial collapse.

Surgery for Dentures

While dentures don’t require the same surgery as dental implants, you are talking about a major extraction. You have to extract all your teeth. This, like dental implants, also requires a healing period of 8 weeks or so.

There are two types of dentures you can get that affect the surgery.

Immediate dentures These are placed right after the teeth are extracted, having two benefits. First, you can walk out the office with your new smile intact. Second, it helps reduce the swelling and bleeding that occurs after having a major teeth extraction. The downside is they’re usually more expensive than conventional dentures because they take more time to make. You’re also required to have more follow-up visits, which are necessary to make adjustments.

Conventional Dentures These require you wait for about eight weeks after the extraction procedure for placement. However, they do tend to fit better than immediate dentures. During the healing process, your tissue will shrink and the immediate dentures will become loose. To aid with that, a soft temporary reline material is placed on the denture for refitting. It takes about six months for your month to completely heal after the extractions and at this time a more permanent reline or new denture is needed.

As you can see, either procedure requires extensive work. So, as I mentioned earlier, ask yourself which one has the best quality of life experience after they’re placed. The answer to that is definitely dental implants.

This blog is brought to you by Dr. Randall Burba.

My Dentist is Gouging Me

I have full snap-on dental implants. I have four posts. I fairly regularly need the locator male retention caps. I’ve looked online, but they only seem to allow dentists to purchase them. Unfortunately, my dentist charges me $30 for one! I can tell they come in sets of four for $20. That’s a huge markup and one I just can’t afford to keep paying. Do I have other options?

Brandon

Dear Brandon,

dental implants anchoring dentures

Ouch! I’m guessing your dentist has high overhead and is using that markup to cover some of that. However, that’s quite a markup. You do want to keep up with your maintenance, especially after investing so much money in your dental implants. I have a couple of options for you that may help.

First, most dentists are very generous people and understand how expensive life can be. You could call around to a different dental office explaining your situation. It’s usually the dental assistant not the dentist who orders those materials using the dentist’s code. You could see if one of them would be willing to order for you and allow you to pay much less than your current dentist, making it affordable for you. You might even find someone who’d be willing to sell it to you at cost.

Another option is ebay. There are dental implant locator caps available there from overseas which don’t require any documentation that you’re a dental professional. They sell for about $20 per set. There is a catch though, it’s important you know EXACTLY what you need, including the resistance. They vary and you don’t want to end up with the wrong ones. Because of that, I’d try other dentists in your area first.

This blog is brought to you by Dr. Randall Burba.